Global AIDS Plan Gets New Addition

A lobbyist discusses the reauthorization process of PEPFAR, the largest commitment by a nation to combat a single disease, and how the new bill has expanded its focus and increased funds by up to $33 billion.

BY Christopher Mangum

August 01 2009 12:00 AM ET

What were the necessary steps in lobbying?

There were a lot of different issues in the language for intravenous drug users, or family planning, linkages for family planning services with HIV services, training for health care workers and I made sure to provide information on MSM and their role in the global epidemic. That also included condensing the research available, meeting with various congressional offices and key decision makers so they can be aware of what’s happening on the ground and why it is so vitally important to specifically target men who have sex with men with prevention education.

What were some of your largest obstacles?

One of the largest obstacles actually is in many countries worldwide same-sex consensual acts between men are criminalized, making data collection difficult. A lot of national HIV surveys don't collect data specifically on men who have sex with men for many reasons. Sometimes it’s not part of the surveillance system, other times it’s really putting men at risk to disclose their sexual behavior because not only is there a lot of stigma and discrimination but it is actually criminalized, as I said, in many countries. So there is not a whole lot of robust data. It’s of one of those circular chicken and egg things -- the people need to see the data to justify the data but without the programming it is difficult to get any of the data.

How then did you ultimately succeed in getting the MSM language incorporated in the bill?

Luckily there are some good studies. There was a 2007 study that looked specifically at the epidemiology of HIV among MSM in low and middle-income countries. There have also been good quality studies and experimental on the ground information, but again, it’s about getting that all together and making it real for decision makers.